U.S. patent number 8,105,373 [Application Number 10/321,044] was granted by the patent office on 2012-01-31 for flexible stent with improved axial strength.
This patent grant is currently assigned to Boston Scientific Scimed, Inc.. Invention is credited to Brent C. Gerberding, Timothy Samuel Girton, Daniel Gregorich.
United States Patent |
8,105,373 |
Girton , et al. |
January 31, 2012 |
Flexible stent with improved axial strength
Abstract
A stent comprises a generally cylindrical band having a pattern
of alternating first and second struts, the first struts being
wider than the second struts, the first and second struts being of
substantially the same length.
Inventors: |
Girton; Timothy Samuel
(Minneapolis, MN), Gregorich; Daniel (Mound, MN),
Gerberding; Brent C. (Sunnyvale, CA) |
Assignee: |
Boston Scientific Scimed, Inc.
(Maple Grove, MN)
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Family
ID: |
32507023 |
Appl.
No.: |
10/321,044 |
Filed: |
December 16, 2002 |
Prior Publication Data
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Document
Identifier |
Publication Date |
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US 20040117002 A1 |
Jun 17, 2004 |
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Current U.S.
Class: |
623/1.15 |
Current CPC
Class: |
A61F
2/91 (20130101); A61F 2/915 (20130101); A61F
2002/91558 (20130101); A61F 2002/91541 (20130101); A61F
2002/91525 (20130101) |
Current International
Class: |
A61F
2/06 (20060101) |
Field of
Search: |
;623/1.1,1.11-1.54,11.11,12 ;606/191-200 |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
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0 800 801 |
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Oct 1997 |
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EP |
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679372 |
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Jul 1999 |
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EP |
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1 190 685 |
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Mar 2002 |
|
EP |
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Primary Examiner: Isabella; David
Assistant Examiner: Schillinger; Ann
Attorney, Agent or Firm: Vidas, Arrett & Steinkraus,
P.A.
Claims
The invention claimed is:
1. A stent comprising a plurality of serpentine generally
cylindrical bands, bands which are adjacent one another connected
one to the other, at least one of the bands formed in a pattern of
alternating first and second struts extending between turns,
wherein each first strut is located adjacent to and between two
second struts and each second strut is located adjacent to and
between two first struts, the first struts being stronger than the
second struts, the first and second struts being of substantially
the same length; wherein the first struts are formed of a different
material than the second struts.
2. The stent of claim 1 wherein the first struts have a greater
width than the second struts.
3. The stent of claim 1 wherein the first struts have a greater
thickness than the second struts.
4. The stent of claim 1 wherein the first struts have a greater
resistance to radial deformation than the second struts.
5. The stent of claim 1 wherein at least one of the bands is in the
form of a closed cylinder.
6. The stent of claim 1 wherein all of the bands are in the form of
closed cylinders.
7. The stent of claim 1 wherein the first struts are at least twice
as wide as the second struts.
8. The stent of claim 1 wherein each of the bands is formed in a
pattern of alternating first and second struts, the first struts
being stronger than the second struts, the first and second struts
being of substantially the same length.
9. A stent comprising a plurality of serpentine generally
cylindrical bands, bands which are adjacent one another connected
one to the other, at least one of the bands formed in a pattern of
alternating first and second struts extending between turns, each
of the first and second struts extending between one turn at a
proximal end of the band and another turn at the distal end of the
band, wherein each first strut is located adjacent to and between
two second struts and each second strut is located adjacent to and
between two first struts, the first and second struts extending in
a substantially longitudinal direction, the first struts being
stronger than the second struts; wherein the first struts are
formed of a different material than the second struts.
10. The stent of claim 9 wherein the first and second struts are of
substantially the same length.
11. The stent of claim 9 wherein the first struts have a greater
width than the second struts.
12. The stent of claim 9 wherein the first struts have a greater
thickness than the second struts.
13. The stent of claim 9 wherein the first struts have a greater
resistance to radial deformation than the second struts.
14. The stent of claim 9 wherein at least one of the bands is in
the form of a closed cylinder.
15. The stent of claim 9 wherein all of the bands are in the form
of closed cylinders.
16. The stent of claim 9 wherein the first struts are at least
twice as wide as the second struts.
17. The stent of claim 9 wherein each of the bands is formed in a
pattern of alternating first and second struts, the first struts
being stronger than the second struts.
18. The stent of claim 9 wherein the first struts are of a
substantially constant width and the second struts are of a
substantially constant width.
19. The stent of claim 9 wherein each of the first struts are of a
varying width and each of the second struts are of a varying width,
the average width of the first struts exceeding the average width
of the second struts.
20. The stent of claim 9 wherein each turn has a width which tapers
toward a narrower strut.
21. The stent of claim 9 wherein the second struts are deformed as
the stent changes between an unexpanded state and an expanded state
and the first struts are not substantially deformed between an
unexpanded state and an expanded state.
22. The stent of claim 9 in a self-expanding configuration.
23. The stent of claim 9 configured for placement in a cerebral
aneurysm.
24. The stent of claim 9 wherein the struts each have a length of
between about 1 mm and 2 mm.
25. A stent comprising a first, second and third serpentine
substantially circumferential band, each serpentine band having a
plurality of turns with struts extending therebetween, the second
band disposed between the first and third bands, and connected to
the first band via a plurality of first connections and the second
band connected to the third band via a plurality of second
connections, the second band being arranged in an alternating
pattern of wide and narrow struts, each wide strut disposed between
two narrow struts and each narrow strut disposed between two wide
struts, the wide struts and the narrow struts having the same
length, there being at least three struts of the second band
extending between first and second connections which are nearest
one another.
26. The stent of claim 25, wherein three struts of the second band
extend between first and second connections which are nearest one
another, one of the three struts being wider than the other of the
three struts.
27. The stent of claim 26 wherein the wider struts extend from a
connection.
28. The stent of claim 26 wherein the connections extend in a
longitudinal direction.
29. The stent of claim 26 wherein the struts are bent.
30. The stent of claim 25 wherein the first and third serpentine
bands each have a first number of turns and the second serpentine
band has a second number of turns, the first number exceeding the
second number.
31. The stent of claim 25 wherein the first and third serpentine
bands are of greater longitudinal extent than the second serpentine
band.
32. The stent of claim 31 wherein the first and third serpentine
bands each have a first number of turns and the second serpentine
band has a second number of turns, the frist number exceeding the
second number.
Description
BACKGROUND OF THE INVENTION
Stents are used in a wide array of bodily vessels including
coronary arteries, renal arteries, peripheral arteries including
iliac arteries, arteries of the neck and cerebral arteries as well
as in other body structures, including but not limited to arteries,
veins, biliary ducts, urethras, fallopian tubes, bronchial tubes,
the trachea, the esophagus and the prostate.
Stents are typically balloon-expandable, self-expanding or a hybrid
of the two. Balloon expandable stents may be made from a wide array
of biocompatible materials including, for example, stainless steel.
Self-expanding stents may also be made from a wide range of
materials including biocompatible shape-memory materials including
metals and polymers. An example of a suitable shape-memory metal is
Nitinol.
In spite of the myriad of stent designs, there remains a need for
novel stent designs as the technology of stent delivery progresses
and as stents are employed with increasing prevalence in a variety
of regions of the body.
As an example of the former, with the ever-increasing demand for
stents to treat bodily vessels, there has been a demand for more
flexible and trackable stents and stent delivery systems. One of
the most significant recent changes to the stent delivery system
involves the use of thin-walled balloons. This change has resulted
in earlier cone deployment of the balloon which creates an inclined
plane resulting in an inward axial force to the stent. The inward
force, in turn, results in increased foreshortening of the stent
upon deployment. Although a number of stents have been developed
that are said to resist foreshortening, novel stent designs that
generally resist foreshortening and in particular resist
foreshortening when delivered on the newer thin walled balloons,
are desirable.
As an example of the latter, in the area of aneurysm stenting, it
is desirable for the stent to have relatively low radial strength
to avoid dilating and rupturing the aneurysm. Standard techniques
for reducing radial strength, however, typically result in stents
which are not visible under fluoroscopy without the addition of
radiopaque materials to the stent. The addition of radiopaque
materials to the stent may alter the profile of the stent in the
regions of the radiopaque material and may complicate the
production of the stent. Thus, there is a need for novel aneurysm
stents which are of low radial strength and which are visible under
fluoroscopy.
All US patents and applications and all other published documents
mentioned anywhere in this application are incorporated herein by
reference in their entirety.
The invention in various of its embodiment is summarized below.
Additional details of the invention and/or additional embodiments
of the invention may be found in the Detailed Description of the
Invention below.
SUMMARY OF THE INVENTION
The invention, in one embodiment, is directed to a stent comprising
a generally cylindrical band having a pattern of alternating first
and second struts. The first struts are wider than the second
struts and are of substantially the same length. Desirably, the
first struts are at least twice as wide as the second struts. The
struts may be straight or may include curved or bent sections.
Typically, the stent will comprise a plurality of the serpentine
generally cylindrical band. Serpentine generally cylindrical bands
which are adjacent one another are connected one to the other.
Desirably, at least one and more desirably, all of the serpentine
generally cylindrical bands are in the form of a closed
cylinder.
The invention is also directed to a stent comprising a plurality of
serpentine generally cylindrical bands where serpentine generally
cylindrical bands which are adjacent one another are connected one
to the other. At least one of the serpentine generally cylindrical
bands is formed in a pattern of alternating first and second
struts. The first struts are stronger than the second struts and
are of substantially the same length. In one embodiment, the first
struts have a greater width than the second struts. Desirably, the
first struts are at least twice as wide as the second struts. In
another embodiment, the first struts have a greater thickness than
the second struts. Desirably, the first struts will have a greater
resistance to radial deformation that the second struts. The first
and second struts may be made of the same material or of a
different material. Desirably, at least one and more desirably, all
of the serpentine generally cylindrical bands are in the form of a
closed cylinder.
The invention is also directed to a stent comprising a plurality of
interconnected serpentine generally cylindrical bands. At least one
of the bands is formed in a pattern of alternating first and second
struts, the first and second struts extending in a substantially
non-circumferential direction. The first struts are stronger than
the second struts. The first and second struts may be of
substantially the same length or of different lengths. In one
embodiment, the first struts have a greater width than the second
struts. Desirably, the first struts are at least twice as wide as
the second struts. In another embodiment, the first struts have a
greater thickness than the second struts. Desirably, the first
struts will have a greater resistance to radial deformation that
the second struts. The first and second struts may be made of the
same material or of a different material. Desirably, at least one
and more desirably, all of the serpentine generally cylindrical
bands are in the form of a closed cylinder.
The stent may be constructed such that the first struts are of a
substantially constant width and the second struts may are of a
substantially constant width. The stent may also be constructed
such that each of the first struts are of a varying width and each
of the second struts are of a varying width, the average width of
the first struts exceeding the average width of the second
struts.
The invention is also directed to a stent comprising a plurality of
interconnected serpentine generally cylindrical bands. At least one
of the bands is formed in a pattern of alternating first and second
struts, each first strut having an average width wider than the
average width of each second strut. The first and second struts are
of substantially the same length.
The invention is also directed to a stent comprising a plurality of
serpentine generally cylindrical bands. Bands which are adjacent
one another are connected one to the other. At least one of the
bands is formed in a pattern of alternating first and second struts
with each first strut having a first width and each second strut
having a second width of no greater than about one-half of the
first width. Desirably, the first width is at least 0.006'' and the
second width is about 0.003''.
The invention is also directed to a stent comprising a serpentine,
generally cylindrical band. The band has a plurality of turns with
struts extending therebetween. The struts include wider struts and
narrower struts and are arranged in a pattern of alternating
widths. Typically, the stent will comprise a plurality of the
cylindrical band. Cylindrical bands which are adjacent one another
are connected one to the other. Desirably, each turn has a width
which tapers toward a narrower strut.
Typically, the stent is constructed such that the orientation of
the narrower struts relative to a longitudinal axis of the stent
changes between an unexpanded state of the stent and an expanded
state of the stent and the orientation of the wider struts relative
to a longitudinal axis of the stent does not significantly change
between an unexpanded state of the stent and an expanded state of
the stent. The narrower struts may deform as the stent changes
between an unexpanded state and an expanded state while the wider
struts do not substantially deform between an unexpanded state and
an expanded state.
The invention is also directed to a stent comprising a serpentine,
generally cylindrical first band having a plurality of turns with
struts extending therebetween. The struts include wider struts and
narrower struts and are arranged in a regular pattern of one or
more wider struts and one or more narrower struts. In one
embodiment, the regular pattern consists of a wider strut adjacent
to a narrower strut. In another embodiment, the regular pattern
consists of a wider strut adjacent to a narrow strut with the
narrow strut adjacent to another narrow strut.
Typically, the stent will comprise a plurality of the first band,
first bands which are adjacent one another connected one to the
other. In one embodiment, the adjacent first bands may be connected
via straight or curved connectors. In another embodiment, second
serpentine bands may be disposed between adjacent first bands. The
first and second bands may be of different wavelengths and
amplitudes. The struts may be straight or may have one or more bent
or curved portions.
The invention is also directed to a stent comprising a plurality of
serpentine bands extending about the circumference of the stent.
Serpentine bands which are adjacent one another are connected one
to the other. At least some of the serpentine bands have first and
second struts, the second struts reorienting on expansion of the
stent, the first struts not substantially reorienting on expansion
of the stent.
The invention is also directed to a stent comprising a first,
second and third serpentine substantially circumferential band.
Each serpentine band has a plurality of interconnected struts. The
second band is disposed between the first and third bands and
connected to the first band via a plurality of first connections
and the second band is connected to the third band via a plurality
of second connections. At least three struts of the second band
extend between first and second connections which are nearest one
another. At least one of the at least three struts is wider than
the other of the at least three struts. Desirably, three struts of
the second band extend between first and second connections which
are nearest one another, one of the three struts being wider than
the other of the three struts. Even more desirably, the wider
struts extend from a connection.
The connections may extend angularly or in a longitudinal
direction. The struts may be straight or bent.
In one embodiment, the first and third serpentine bands each have a
first number of turns and the second serpentine band has a second
number of turns, the first number exceeding the second number. The
first and third serpentine bands may be of greater longitudinal
extent than the second serpentine band.
The inventive stents may be provided in a self-expanding
configuration, in a balloon expandable configuration or in a hybrid
configuration.
The inventive stents may be configured for placement in any
suitable bodily vessel disclosed herein. Where the stent is
configured for use in cerebral vessels, the struts will typically
have lengths of between about 1 mm and 2 mm.
Additional details and/or embodiments of the invention are
discussed below.
BRIEF DESCRIPTION OF DRAWINGS
FIG. 1a is a flat pattern of an inventive stent.
FIG. 1b shows several adjacent struts of the stent of FIG. 1 prior
to expansion of the stent.
FIG. 1c shows the struts of FIG. 1b during expansion of the
stent.
FIG. 2 is a flat pattern of an end of an inventive stent.
FIG. 3 is a flat pattern of an end of an inventive stent.
FIG. 4a is a flat pattern of an inventive stent.
FIG. 4b shows an enlarged view of region A of the stent shown in
flat layout view in FIG. 4a.
FIG. 5a is a flat pattern of an inventive stent.
FIG. 5b shows an enlarged view of region A of the stent shown in
flat layout view in FIG. 5a.
FIG. 6a is a flat pattern of an inventive stent.
FIG. 6b shows an enlarged view of region A of the stent shown in
flat layout view in FIG. 6a.
FIG. 7a is a flat pattern of an inventive stent.
FIG. 7b shows an enlarged view of region A of the stent shown in
flat layout view in FIG. 7a.
FIGS. 8a-8c show a flat pattern of a portion of another inventive
stent along with its response to an axial force.
DETAILED DESCRIPTION OF THE INVENTION
While this invention may be embodied in many different forms, there
are described in detail herein specific preferred embodiments of
the invention. This description is an exemplification of the
principles of the invention and is not intended to limit the
invention to the particular embodiments illustrated.
For the purposes of this disclosure, unless otherwise indicated,
identical reference numerals used in different figures refer to the
same component.
Also for the purposes of this disclosure, the term `bent strut` and
the like does not implicate a method of manufacture and is intended
to include struts which have curves, struts which are angled, and
struts which are curvilinear, regardless of how the struts or the
stent as a whole are manufactured.
Finally, for the purposes of this disclosure, points which are
circumferentially aligned lie along a common line parallel to the
longitudinal axis of the stent. Points which are longitudinally
aligned lie along a common circumference.
In one embodiment, the invention is directed to a stent such as
that shown generally at 100 in FIG. 1a comprising a generally
cylindrical band 105 having a pattern of alternating first and
second struts 108 and 110. The term `generally cylindrical band` is
intended to encompass both bands which extend all the way around
the circumference of the stent as well as bands which extend most,
but not all of the way, around the circumference of the stent. An
example of the latter is a circumferential band which is missing
one or more struts. First struts 108 are wider than second struts
110 and are of substantially the same length as the second struts
110. Desirably, first struts 108 are at least twice as wide as
second struts 110, as shown in FIG. 1a. Circumferentially adjacent
first and second struts are joined at one end of the struts only
via turn 109. The width of the turn decreases from strut 108 to
strut 110. In the embodiment of FIG. 1a, all of the generally
cylindrical bands are provided with the alternating arrangement of
wider and narrower struts.
In other embodiments of the invention, less than all of the bands
have the alternating strut arrangement. For example, the stent of
FIG. 1a may be modified such that one or more proximal and/or
distal bands are provided with struts of uniform width.
Adjacent bands 105 are connected one to the other. Desirably, as
shown in FIG. 1a, adjacent bands are connected via connectors 112.
In the embodiment of FIG. 1a, two straight connectors 112 of a
width intermediate the width of first strut 108 and second strut
110 connect adjacent bands 105. It is within the scope of the
invention to provide wider or narrower connectors, longer or
shorter connectors as well as more or fewer connectors between
adjacent bands. Also, the connector may be curved have one or more
bends and, optionally, one or more straight portions. The first and
second ends of the connectors may be circumferentially aligned, as
shown in FIG. 1 or may be circumferentially offset from one
another.
As shown in FIG. 1a, it is desirable for the connectors to be
arranged such that for each connector 112 extending from one end of
a band, there is a connector 112 extending from the other end of
the band which is separated from the other connector by three
struts.
The stent of FIG. 1a is constructed such that the orientation of
the narrower struts relative to a longitudinal axis of the stent
changes between an unexpanded state of the stent and an expanded
state of the stent and the orientation of the wider struts relative
to a longitudinal axis of the stent does not significantly change
between an unexpanded state of the stent and an expanded state of
the stent. The narrower struts may deform as the stent changes
between an unexpanded state and an expanded state while the wider
struts do not substantially deform between an unexpanded state and
an expanded state. FIGS. 1b and 1c show circumferentially adjacent
wider and narrower struts before (FIG. 1b) and after (FIG. 1c)
expansion of the stent. In FIG. 1b, struts 108 and 110 are parallel
to the longitudinal axis of the stent. In FIG. 1c, wider struts 108
remain substantially parallel to the longitudinal axis of the stent
while narrower struts 110 reorient relative to the longitudinal
axis of the stent.
Without being bound by theory, it is believed that the wider struts
provide axial rigidity and force transfer to points on the narrower
struts that are not conducive to foreshortening.
Other embodiments of the invention are directed to stents having
other arrangements of wider and narrower struts. In the embodiments
of FIGS. 2-7, the struts are arranged in a repeating pattern of two
narrow struts 110 and one wider strut 108. Each wider strut has two
narrower struts on either side of it and each narrower strut has a
narrower strut on one side of it and a wider strut on another side
of it.
In the embodiment of FIGS. 2 and 3, one or both ends of the stent
is provided with one circumferential band 15 with struts 118 of
uniform width. The invention is also directed to embodiments in
which a plurality of bands at one or both ends of the stent have
uniform struts with the remainder of the stent having bands with
the alternating arrangement of the struts. It is also within the
scope of the invention for the stent to have alternating bands of
struts of uniform width and bands of struts of non-uniform width as
shown, by way of example, in FIGS. 4-7.
In the embodiment of FIG. 2, the struts are relatively straight. As
shown in FIGS. 3-7, the inventive stents may also be provided with
bent struts.
In the embodiments of FIGS. 4a-7a and 4b-7b, the stent is provided
with first and second generally cylindrical bands 105 and 115 which
alternate with one another along the length of the stent. The first
generally cylindrical bands are of shorter longitudinal dimension
than the second generally cylindrical bands and have more turns
than the second generally cylindrical bands. Adjacent first and
second generally cylindrical bands are connected one to the other
at least one and desirably a plurality of connectors 112.
In the embodiment of FIGS. 4a-7a and 4b-7b, there are three bent
struts extending between each connector 112 extending from one end
of a first generally cylindrical band 105 and the nearest connector
105 thereto extending from the other end of the first generally
cylindrical band. For every wider strut 108, there are two narrower
struts 110 adjacent thereto.
The embodiments of FIGS. 4a-7a differ from one another in the ratio
of the width of the wider strut to the narrower strut as well as in
the angles of the struts relative to the longitudinal axis of the
stent. Any of the stents shown in copending U.S. application Ser.
No. 10/042,634 may be modified in accordance with the instant
invention.
A portion of another inventive stent is shown in FIG. 8a. The stent
includes alternating first bands 105 and second bands 115. First
bands 105 include wider struts 108 and narrower struts 110. Struts
118 of second band 115 are of uniform width. Adjacent bands are
connected one to the other via connectors 112. As shown in FIG. 8b,
as an axial force F is transmitted along strut 108, it transfers
its force from point D to point C, shown in FIG. 8b. As a result,
joined struts 110 do not have the same freedom to shorten as they
would otherwise have if strut 110 were narrower.
The invention is also directed to a stent comprising a plurality of
serpentine generally cylindrical bands where serpentine generally
cylindrical bands which are adjacent one another are connected one
to the other and at least one of the serpentine generally
cylindrical bands is formed in a pattern of first and second
struts. The first struts are stronger than the second struts and
are of substantially the same length. In one embodiment, the first
struts have a greater width than the second struts. Desirably, the
first struts are at least twice as wide as the second struts. An
example of such a stent is shown in FIG. 1a. The first, stronger
struts are shown at 108 and the second, weaker struts are shown at
110.
In another embodiment, not shown, the first struts are stronger in
that they have a greater thickness than the second struts.
Desirably, the first struts will have a greater resistance to
radial deformation that the second struts. The first and second
struts may be made of the same material or of a different material.
Desirably, at least one and more desirably, all of the serpentine
generally cylindrical bands are in the form of a closed
cylinder.
In the various embodiments of the invention, disclosed herein, the
first and second struts may be made of the same material or of
different materials.
In some embodiments of the invention, as shown for example in FIG.
1, the stent may be constructed such that the first struts are of a
substantially constant width and the second struts may are of a
substantially constant width. In other embodiments of the
invention, the stent may be constructed such that each of the first
struts are of a varying width and each of the second struts are of
a varying width, the average width of the first struts exceeding
the average width of the second struts.
The invention is also directed to a stent, such as that shown in
FIG. 1a, comprising a plurality of interconnected serpentine
generally cylindrical bands. At least one of the bands is formed in
a pattern of alternating first and second struts, each first strut
having an average width wider than the average width of each second
strut. The first and second struts are of substantially the same
length.
The invention is also directed to a stent comprising a serpentine,
generally cylindrical first band having a plurality of turns with
struts extending therebetween. The struts include wider struts and
narrower struts and are arranged in a regular pattern of one or
more wider struts and one or more narrower struts. In one
embodiment, the regular pattern consists of a wider strut adjacent
to a narrower strut. In another embodiment, the regular pattern
consists of a wider strut adjacent to a narrow strut with the
narrow strut adjacent to another narrow strut.
Typically, the stent will comprise a plurality of the first band,
first bands which are adjacent one another connected one to the
other. The connection may be direct, via one or more straight or
curved structures or may be indirect, in the case where a second
serpentine band of another configuration is disposed between
adjacent first serpentine bands. The first and second bands may be
of different wavelengths and amplitudes.
The struts may be straight or may have one or more bent or curved
portions.
The invention is also directed to a stent, such as that shown by
way of example in FIGS. 2 and 3, comprising a first, second and
third serpentine substantially circumferential band. Each
serpentine band has a plurality of interconnected struts. Second
band 105 is disposed between first and third bands 115a and 115b
and connected to the first band via a plurality of first
connections 112a and the second band is connected to the third band
via a plurality of second connections 112b. At least three struts
of the second band extend between first and second connections
which are nearest one another. At least one of the at least three
struts is a wider strut 108 than the other of the at least three
struts 110. Desirably; three struts of the second band extend
between first and second connections 112a and 112b which are
nearest one another, one of the three struts being wider than the
other of the three struts. Even more desirably, as shown in FIGS. 2
and 3, the wider struts 108 extend from a connection 112.
The connections may extend angularly or in a longitudinal
direction. The struts may be straight or bent, as shown in FIGS. 2
and 3, respectively.
In one embodiment, the first and third serpentine bands each have a
first number of turns and the second serpentine band has a second
number of turns, the first number exceeding the second number. The
first and third serpentine bands may be of greater longitudinal
extent than the second serpentine band.
The inventive stents may be provided in a self-expanding
configuration, in a balloon expandable configuration or in a hybrid
configuration.
The inventive stents may be configured for placement in any
suitable bodily vessel disclosed herein.
Where the stent is configured for use in cerebral vessels, the
struts will typically have lengths of between about 1 mm and 2 mm.
As a non-limiting example, the stent of FIG. 1a may be provided in
an embodiment in which the struts are 1 mm to 2 mm in length or
less. Such a stent, desirably self-expanding, would have at least
some struts which are desirably thick enough and wide enough to be
seen under fluoroscopy. As an example, where the stent has a wall
thickness of approximately 0.003'', the wider struts will desirably
have a width of 0.0065'' or more so that they may be viewed under
fluoroscopy and the narrower struts, desirably, will be of no more
than half the width of the wider struts and more desirably,
approximately 0.003'' or less. Desirably, as shown in FIG. 1, the
turns between the wider struts and the narrower struts gradually
tapers in width from the width of the wider struts to the width of
the narrower struts. The stent may be provided in a range of
diameters, depending on the diameter of the vessel in which it is
to be inserted. Suitable diameters include 3 mm or smaller. The
stent may also be provided in larger diameters as well. The stent
may be used in stenting aneurysms. Suitable materials for such a
stent include shape-memory materials such as Nitinol and
spring-metal materials. Because it is desirable for self-expanding
aneurysm stents to have reduced radial strength so as not to dilate
the aneurysm, such stents will typically have reduced strut
dimensions. The fat-skinny design of the stent of FIG. 1 not only
allows for novel patterns of force transmission through the stent
but also reduced radial strength as a result of the narrower struts
along with reasonable radiopacity from the wider struts to maintain
the radiopacity necessary to visualize the stent under
fluoroscopy.
A stent such as that shown in FIG. 1 may be made of a shape-memory
material such as Nitinol. In one embodiment, the stent pattern may
be cut into a Nitinol tube and the tube expanded and heatset into
shape using standard techniques for handling Nitinol. With such a
stent, bending of the stent would occur mostly as a result of
deformation of the thinner struts with the wider struts remaining
largely undeformed.
Any of the inventive stents disclosed above may be provided with a
uniform diameter or may taper in portions or along the entire
length of the stent.
The invention is also directed to bifurcated stents. Any or all of
the branches of a bifurcated stent and or the trunk may be provided
with one or more generally cylindrical bands with wider and
narrower struts as disclosed above.
The inventive stents may be manufactured using known stent
manufacturing techniques including laser cutting, laser welding,
chemically etching, electrode discharge machining or stamping a
tube or a sheet. In the case of a sheet, the sheet is then rolled
and welded. The inventive stents may also be molded with the
desired design or may be made by growing or extruding or winding a
stent with the inventive patterns. Further, the inventive stents
may be assembled by providing individual generally cylindrical
bands and connecting them together via welding or any other
suitable joining technique.
Typically, in the case of stents which are laser cut from tubes or
sheets, the laser cut tube or sheet will have to be polished using
suitable polishing techniques as known in the art and cleaned using
suitable cleaning techniques as known in the art.
Any suitable stent material may be used in the manufacture of the
inventive stents. Examples of such materials include metals such as
stainless steel, tantalum, elgiloy and shape memory metals such as
nitinol, platinum/tungsten alloys and titanium alloys. The
inventive stents may also be made of suitable polymeric
materials.
The inventive stents may include suitable radiopaque coatings. For
example, the stents may be coated with gold or other noble metals
or sputtered with tantalum or the like. The stents may also be made
directly from a radiopaque material to obviate the need for a
radiopaque coating or may be made of a material having a radiopaque
inner core. The entirety of the stent may include one or more
radiopaque coatings or the radiopaque coatings may be limited to
desired portions of the stent. In the case of the stent of FIG. 1a,
although a radiopaque coating may be provided, the wider struts are
typically configured to provide the stent with radiopacity.
The inventive stents may also be provided with various
bio-compatible coatings to enhance various properties of the stent.
For example, the inventive stents may be provided with lubricious
coatings. The inventive stents may also be provided with
drug-containing coatings which release drugs over time.
The coating may comprise one or more non-genetic therapeutic
agents, genetic materials and cells and combinations thereof as
well as other polymeric coatings.
Non-genetic therapeutic agents include anti-thrombogenic agents
such as heparin, heparin derivatives, urokinase, and PPack
(dextrophenylalanine proline arginine chloromethylketone);
anti-proliferative agents such as enoxaprin, angiopeptin, or
monoclonal antibodies capable of blocking smooth muscle cell
proliferation, hirudin, and acetylsalicylic acid; anti-inflammatory
agents such as dexamethasone, prednisolone, corticosterone,
budesonide, estrogen, sulfasalazine, and mesalamine;
antineoplastic/antiproliferative/antimiotic agents such as
paclitaxel, 5-fluorouracil, cisplatin, vinblastine, vincristine,
epothilones, endostatin, angiostatin and thymidine kinase
inhibitors; anesthetic agents such as lidocaine, bupivacaine, and
ropivacaine; anticoagulants such as D-Phe-Pro-Arg chloromethyl
keton, an RGD peptide-containing compound, heparin, antithrombin
compounds, platelet receptor antagonists, antithrombin anticodies,
anti-platelet receptor antibodies, aspirin, prostaglandin
inhibitors, platelet inhibitors and tick antiplatelet peptides;
vascular cell growth promotors such as growth factor inhibitors,
growth factor receptor antagonists, transcriptional activators, and
translational promotors; vascular cell growth inhibitors such as
growth factor inhibitors, growth factor receptor antagonists,
transcriptional repressors, translational repressors, replication
inhibitors, inhibitory antibodies, antibodies directed against
growth factors, bifunctional molecules consisting of a growth
factor and a cytotoxin, bifunctional molecules consisting of an
antibody and a cytotoxin; cholesterol-lowering agents; vasodilating
agents; and agents which interfere with endogenous vascoactive
mechanisms.
Genetic materials include anti-sense DNA and RNA, DNA coding for,
anti-sense RNA, tRNA or rRNA to replace defective or deficient
endogenous molecules, angiogenic factors including growth factors
such as acidic and basic fibroblast growth factors, vascular
endothelial growth factor, epidermal growth factor, transforming
growth factor .alpha. and .beta., platelet-derived endothelial
growth factor, platelet-derived growth factor, tumor necrosis
factor .alpha., hepatocyte growth factor and insulin like growth
factor, cell cycle inhibitors including CD inhibitors, thymidine
kinase ("TK") and other agents useful for interfering with cell
proliferation the family of bone morphogenic proteins ("BMP's"),
BMP-2, BMP-3, BMP-4, BMP-5, BMP-6 (Vgr-1), BMP-7 (OP-1), BMP-8,
BMP-9, BMP-10, BMP-11, BMP-12, BMP-13, BMP-14, BMP-15, and BMP-16.
Desirable BMP's are any of BMP-2, BMP-3, BMP-4, BMP-5, BMP-6 and
BMP-7. These dimeric proteins can be provided as homodimers,
heterodimers, or combinations thereof, alone or together with other
molecules. Alternatively or, in addition, molecules capable of
inducing an upstream or downstream effect of a BMP can be provided.
Such molecules include any of the "hedgehog" proteins, or the DNA's
encoding them.
Cells can be of human origin (autologous or allogeneic) or from an
animal source (xenogeneic), genetically engineered if desired to
deliver proteins of interest at the transplant site. The cells may
be provided in a delivery media. The delivery media may be
formulated as needed to maintain cell function and viability.
Suitable polymer coating materials include polycarboxylic acids,
cellulosic polymers, including cellulose acetate and cellulose
nitrate, gelatin, polyvinylpyrrolidone, cross-linked
polyvinylpyrrolidone, polyanhydrides including maleic anhydride
polymers, polyamides, polyvinyl alcohols, copolymers of vinyl
monomers such as EVA, polyvinyl ethers, polyvinyl aromatics,
polyethylene oxides, glycosaminoglycans, polysaccharides,
polyesters including polyethylene terephthalate, polyacrylamides,
polyethers, polyether sulfone, polycarbonate, polyalkylenes
including polypropylene, polyethylene and high molecular weight
polyethylene, halogenated polyalkylenes including
polytetrafluoroethylene, polyurethanes, polyorthoesters, proteins,
polypeptides, silicones, siloxane polymers, polylactic acid,
polyglycolic acid, polycaprolactone, polyhydroxybutyrate valerate
and blends and copolymers thereof, coatings from polymer
dispersions such as polyurethane dispersions (for example,
BAYHDROL.RTM.), fibrin, collagen and derivatives thereof,
polysaccharides such as celluloses, starches, dextrans, alginates
and derivatives, hyaluronic acid, squalene emulsions. Polyacrylic
acid, available as HYDROPLUS.RTM. (Boston Scientific Corporation,
Natick, Mass.), and described in U.S. Pat. No. 5,091,205, the
disclosure of which is hereby incorporated herein by reference, is
particularly desirable. Even more desirable is a copolymer of
polylactic acid and polycaprolactone.
The inventive stents may also be used as the framework for a graft.
Suitable coverings include nylon, collagen, PTFE and expanded PTFE,
polyethylene terephthalate and KEVLAR, or any of the materials
disclosed in U.S. Pat. Nos. 5,824,046 and 5,755,770. More
generally, any known graft material may be used including synthetic
polymers such as polyethylene, polypropylene, polyurethane,
polyglycolic acid, polyesters, polyamides, their mixtures, blends
and copolymers.
The inventive stents may be configured for use in a wide array of
bodily vessels including coronary arteries, renal arteries,
peripheral arteries including iliac arteries, arteries of the neck
and cerebral arteries as well as in other body structures,
including but not limited to arteries, veins, biliary ducts,
urethras, fallopian tubes, bronchial tubes, the trachea, the
esophagus and the prostate.
In addition to the specific embodiments claimed below, the
invention is also directed to other embodiments having any other
possible combination of the dependent features claimed below. As
such, the particular features presented in the dependent claims can
be combined with each other in other manners within the scope of
the invention such that the invention should be recognized as also
specifically directed to other embodiments having any other
possible combination of the features of the dependent claims. For
instance, for purposes of claim publication, any dependent claim
which follows should be taken as alternatively written in a
multiple dependent form from all prior claims which possess all
antecedents referenced in such dependent claim if such multiple
dependent format is an accepted format within the jurisdiction
(e.g. each claim depending directly from claim 1 should be
alternatively taken as depending from all previous claims). In
jurisdictions where multiple dependent claim formats are
restricted, the following dependent claims should each be also
taken as alternatively written in each singly dependent claim
format which creates a dependency from a prior
antecedent-possessing claim other than the specific claim listed in
such dependent claim below (e.g. Claim 3 may be taken as
alternatively dependent from claim 1; claim 4 may be taken as
alternatively dependent on claim 3, or on claim 1; claim 5 may be
taken as alternatively dependent from any of claims 1-4, etc.).
The above disclosure is intended to be illustrative and not
exhaustive. This description will suggest many variations and
alternatives to one of ordinary skill in this art. All these
alternatives and variations are intended to be included within the
scope of the attached claims. Those familiar with the art may
recognize other equivalents to the specific embodiments described
herein which equivalents are also intended to be encompassed by the
claims attached hereto.
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